What is Known About Caries in Relation to Restorations as a Reason for Replacement? a Review

Abstract

In the past 20 years, a great many studies have identified secondary caries to be the most common reason for the replacement of restorations. This review raises the question whether clinicians use 'secondary caries' as a catch-all into which they put a variety of reasons for replacement, or whether they do have professionally based reasons for focusing on caries adjacent to restorations. There is no consensus among researchers concerning the nature of secondary caries, but it is possible to identify two major-and conflicting-trends : One adheres to a critical approach concerning the frequency of replacements and recommends a much more conservative evaluation of existing fillings. In contrast, the other trend focuses on the clinical undetectable microleakage as the major risk factor for the initiation and uncontrolled dentinal spread of secondary caries. Since the latter trend offers a reasonable explanation for the clinicians' concern about invisible 'secondary caries', and hence reinforces the tendency to replacement, it is relevant to reconsider the conventional concept that microleakage leads to the initiation of secondary caries.

Available data indicate that visible gaps and marginal discrepancies are poorly related to secondary caries, and that secondary caries is a localized phenomenon caused by localized conditions for the evolution of cariogenic plaque. Consequently, secondary caries is not a universal attack along the entire interface between tooth and restoration, but rather a new lesion or a re-beginning of caries on the surface due to local conditions for plaque formation with cariogenic potential.

It is concluded that reinforcement of a new and more appropriate professional behavior should be based on diffusion of existing knowledge of dental caries as a disease rather than on simplified criteria for the placement and replacement of dental restorations.

Keywords

secondary (recurrent) caries dental plaque marginal leakage replacement.

Get full access to this article

View all access options for this article.

References

Allander L. , Birkhed D. , Bratthall D. (1990). Reasons for replacement of class II amalgam restorations in private practice. Swed Dent J 14:179-184.

Anusavice KJ , editor (1989). Quality evaluation of dental restorations: criteria for placement and replacement . Chicago, IL: Quintessence Publishing Co., Inc.

Bader JD , Shugars DA (1992). Understanding dentists' restorative treatment decisions. J Public Health Dent 52:102-110.

Bader JD , Shugars DA (1993). Agreement among dentists' recommendations for restorative treatment. J Dent Res 72:891-896.

Black GV (1914). A work on operative dentistry. 2nd ed. Vols. I-II. Chicago: Medico-Dental Publishing Company.

Boucher CO , editor (1963). Current clinical dental terminology. St. Louis: The C.V. Mosby Company, p. 58.

Boyd MA ( 1989). Amalgam replacement: are decisions based on fact or tradition ? In: Quality evaluation of dental restorations: criteria for placement and replacement. Anusavice KJ , editor. Chicago, IL: Quintessence Publishing Co., Inc., pp. 73-82.

Boyd MA , Richardson AS (1985). Frequency of amalgam replacement in general dental practice. J Can Dent Assoc 10:763-766.

Carvalho JC , Ekstrand KR , Thylstrup A. (1989). Dental plaque and caries on occlusal surfaces of first permanent molars in relation to stage of eruption. J Dent Res 68:773-779.

10.

Carvalho JC , Ekstrand KR , Thylstrup A. (1991). Results after 1 year of non-operative occlusal caries treatment of erupting permanent first molars. Community Dent Oral Epidemiol 19:23-28.

11.

Carvalho JC , Thylstrup A. , Ekstrand KR (1992). Results after 3 years of non-operative occlusal caries treatment of erupting permanent first molars. Community Dent Oral Epidemiol 20:187-192.

12.

Charbeneau GT (1989). Criteria for treatment of caries based on patient risk classification. In: Quality evaluation of dental restorations: criteria for placement and replacement. Anusavice KJ , editor. Chicago, IL: Quintessence Publishing Co., Inc., pp. 169-184.

13.

Churchill's illustrated medical dictionary ( 1989). New York, NY: Churchill Livingstone Inc., pp. 301, 510.

14.

Cox CF (1992). Microleakage related to restorative procedures . Proc Finn Dent Soc 88(Suppl 1):83-93.

15.

Dahl JE , Eriksen HM (1978). Reasons for replacement of amalgam dental restorations . Scand J Dent Res 86:404-407.

16.

Dorland's illustrated medical dictionary (1988). 27th ed. Philadelphia, PA: W.B. Saunders Company, pp. 275, 461.

17.

Eisenberg JM , Foster NE (1993). Bridging the gap between theory and practice: exploring clinical practice guidelines. National quality of care forum. Jt Comm J Qual Improv 19:384-400.

18.

Ekstrand KR , Kuzmina I. , Bjørndal L. , Thylstrup A. (1995). The relationship between external and histologic features of progressive stages of caries in the occlusal fossa. Caries Res 29: 243-250.

19.

Elderton RJ (1989). Variability in the decision-making process and implications for change toward a preventive philosophy. In: Quality evaluation of dental restorations: criteria for placement and replacement . Anusavice KJ , editor. Chicago, IL: Quintessence Publishing Co., Inc., pp. 210-222.

20.

Elderton RJ , Nuttall NM (1983). Variation among dentists in planning treatment . Br Dent J 154:201-206.

21.

Eriksen HM , Bjertness E. , Hansen BF (1986). Cross-sectional clinical study of quality of amalgam restorations, oral health and prevalence of recurrent caries. Community Dent Oral Epidemiol 14:15-18.

22.

Espelid I. , Tveit AB , Haugejorden O. , Riordan PJ (1985). Variation in radiographic interpretation and restorative treatment decision on approximal caries among dentists in Norway. Community Dent Oral Epidemiol 13:26-29.

23.

Goldberg J. , Tanzer J. , Munster E. , Amara J. , Thal F. , Birkhed D. (1981). Cross-sectional clinical evaluation of recurrent enamel caries, restoration of marginal integrity, and oral hygiene status . J Am Dent Assoc 102:635-641.

24.

Hals E. , Kvinnsland I. (1974). Structure of experimental in vivo and in vitro lesions around composite (Addent XV®) fillings. Scand J Dent Res 82:517-526.

25.

Hals E. , Nernaes A. (1971). Histopathology of in vitro caries developing around silver amalgam fillings. Caries Res 5:58-77.

26.

Hewlett ER , Atchison KA , White SC , Flack V. (1993). Radiographic secondary caries prevalence in teeth with clinically defective restorations. J Dent Res 72:1604-1608.

27.

Jokstad A. , Mjor IA ( 1991). Analyses of long-term clinical behavior of class-II amalgam restorations. Acta Odontol Scand 49:47-63.

28.

Kelsey WP , Franco SJ , Blankenau RJ , Cavel WT , Barkmeier WW (1981). Caries as a cause of restoration replacement: a clinical survey. Quint Int 9:971-974.

29.

Kidd EAM (1976). Microleakage in relation to amalgam and composite restorations. A laboratory study. Br Dent J 141:305-310.

30.

Kidd EAM (1981). Secondary caries. Dent Update 8:253-260.

31.

Kidd EAM (1989a). Caries diagnosis within restored teeth. In: Quality evaluation of dental restorations: criteria for placement and replacement. Anusavice KJ , editor. Chicago, IL: Quintessence Publishing Co., Inc., pp. 111-123.

32.

Kidd EAM (1989b). Caries diagnosis within restored teeth. Oper Dent 14:149-158.

33.

Kidd EAM , O'Hara JW (1990). The caries status of occlusal amalgam restorations with marginal defects. J Dent Res 69:1275-1277.

34.

Kidd EAM , Toffenetti F. , Mjor IA ( 1992). Secondary caries. Int Dent J 42:127-138.

35.

Kidd EAM , Joyston-Bechal S. , Beighton D. (1994). Diagnosis of secondary caries: a laboratory study . Br Dent J 176:135-139.

36.

Klausner LH , Green TG , Charbeneau GT (1987). Placement and replacement of amalgam restorations: a challenge for the profession. Oper Dent 12:105-112.

37.

Konig KG (1966). Finding in serially sectioned teeth showing early fissure lesions. Adv Fluorine Res 4:73-79.

38.

Krasse BG (1989). Prediction and prevention of recurrent caries based on microbiological assays. In: Quality evaluation of dental restorations: criteria for placement and replacement. Anusavice KJ , editor. Chicago, IL: Quintessence Publishing Co., Inc., pp. 199-209.

39.

Lavelle CLB (1976). A cross-sectional longitudinal survey into the durability of amalgam restorations. J Dent 4:139-143.

40.

Maclnnis WA , Ismail A. , Brogan H. (1991). Placement and replacement of restorations in a military population. J Can Dent Assoc 57:227-231.

41.

Manhold JH , Balbo MP , editors (1985). Illustrated dental terminology . Philadelphia, PA: J.B. Lippincott Company, p. 209.

42.

Maryniuk GA (1990). Practice variation: learned and socio-economic factors. Adv Dent Res 4:19-24.

43.

Merrett MCW , Elderton RJ (1984). An in vitro study of restorative dental treatment decisions and dental caries. Br Dent J 157:128-133.

44.

Mileman P. , Purdell-Lewis D. , Van der Weele L. (1982). Variation in radiographic caries diagnosis and treatment decisions among university teachers. Community Dent Oral Epidemiol 10:329-334.

45.

Mjor IA ( 1979). Orsaker til revision av fyllningar. Tandläkartidningen 71:552-556.

46.

Mjor IA ( 1980). Revision av fyllningar. Tandläkartidningen 72:375-380.

47.

Mjor IA ( 1981). Placement and replacement of restorations. Oper Dent 6:49-54.

48.

Mjor IA ( 1985a). Frequency of secondary caries at various anatomical locations. Oper Dent 10:88-92.

49.

Mjor IA , editor (1985b). Dental materials: biological properties and clinical evaluations. Boca Raton, FL: CRC Press.

50.

Mjor IA ( 1992). Long term cost of restorative therapy using different materials. Scand J Dent Res 100:60-65.

51.

Mjor IA , Toffenetti F. (1992). Placement and replacement of restorations in Italy . Oper Dent 17:70-73.

52.

Newbrun E. (1993). Problems in caries diagnosis. Int Dent J 43:133-142.

53.

Pink FE , Minden NJ , Simmonds S. (1994). Decisions of practitioners regarding placement of amalgam and composite restorations in general practice settings. Oper Dent 19:127-132.

54.

Qvist V. (1993). Resin restorations: leakage, bacteria, pulp. Endod Dent Traumatol 9:127-152.

55.

Qvist V. , Thylstrup A. , Mjor IA ( 1986). Restorative treatment pattern and longevity of amalgam restorations in Denmark. Acta Odontol Scand 44:343-349.

56.

Qvist J. , Qvist Q. , Mjor IA ( 1990). Placement and longevity of amalgam restorations in Denmark . Acta Odontol Scand 48:297-303.

57.

Richardson AS , Boyd MA ( 1973). Replacement of silver amalgam restorations by 50 dentists during 246 working days. J Can Dent Assoc 8:556-559.

58.

Rytomaa I. , Jarvinen V. , Jarvinen J. (1979). Variation in caries recording and restorative treatment plan among university teachers. Community Dent Oral Epidemiol 7:335-339.

59.

Soderholm KJ , Antonson DE , Fischlschweiger W. (1989). Correlation between marginal discrepancies at the amalgam/tooth interface and recurrent caries. In: Quality evaluation of dental restorations: criteria for placement and replacement . Anusavice KJ , editor. Chicago, IL: Quintessence Publishing Co., Inc., pp. 95-110.

60.

Theilade J. , Fejerskov O. , Hørsted M (1976). A transmission electron microscopic study of 7-day old bacterial plaque in human tooth fissures. Arch Oral Biol 21:587-598.

61.

Theilade E. , Fejerskov O. , Karring T. , Theilade J. (1978). A microbiological study of old plaque in occlusal fissures of human teeth. Caries Res 12:313-319.

62.

Thylstrup A. , Bille J. , Qvist V. (1986). Radiographic and observed tissue changes in approximal carious lesions at the time of operative treatment. Caries Res 20:75-84.

63.

Thylstrup A. , Chironga L. , de Carvalho J. , Ekstrand KR (1989). The occurrence of dental calculus in occlusal fissures as an indication of caries activity. In: Recent advances in the study of dental calculus. ten Cate JM , editor. Oxford: IRL Press , pp. 211-222.

64.

Thylstrup A. , Bruun C. , Holmen L. (1994). In vivo caries models-mechanisms for caries initiation and arrestment. Adv Dent Res 8:144-157.

65.

York AK , Stephen AJ (1993). Reasons for placement and replacement of dental restorations in the United States Navy dental corps. Oper Dent 18:203-208.